The longest lived among us aren’t necessarily those who are of normal weight, says a new study.

According to new research this week in the Journal of the American Medical Association (JAMA), researchers say that being overweight may lead to a longer life.

The somewhat surprising conclusion comes from an enormous, detailed review of over 100 previously published research papers connecting body weight and mortality risk among 2.88 million study participants living around the world. The new research confirms that obese people, and particularly those who are extremely obese, tend to die earlier than those of normal weight. But the findings also suggest that people who are overweight (but not obese) may live longer than people with clinically normal body weight.

The new report is the largest and most comprehensive review of how weight, measured as body mass index (BMI), a measure comparing the ratio of height to weight, can influence longevity. Previous studies that have exposed the link in the past, however, have raised questions about whether the overweight advantage is real.

“We published an article in 2005 that showed, among other things, that overweight was associated with lower mortality — and we got an awful lot of negative feedback from that,” says the current study’s lead author, Katherine Flegal, a senior research scientist at the Centers for Disease Control and Prevention (CDC). Since that study, however, dozens of others have reached the same conclusion — even if it was hard for researchers and the public to accept.

“I think there’s a lot of under reporting of this finding […] and so people are sort of repeatedly surprised by it,” Flegal says. Because many researchers don’t expect to find a benefit associated with being overweight, she suggests, they may not believe their results are valid if they find such a connection, which may make them more hesitant to publish them and invite review and discussion about what may be driving the trend.

For the new study, Flegal and her colleagues analyzed every study they could find that broke down death risk broken by the standard BMI categories set by the World Health Organization (WHO) in the late 1990s: with underweight defined as BMI less than 18.5, normal weight being BMI between 18.5 and 25, overweight being BMI between 25 and 30, and obese as BMI of over 30. Men or women who are 5’4″ would have “normal” BMI if they weighed between 108 and 145 pounds, for example, and overweight if they weighed 146 to 174 pounds, and obese if weighed more than that.

Overall, people who were overweight but not obese were 6% less likely to die during the average study period than normal-weight people. That advantage held among both men and women, and did not appear to vary by age, smoking status, or region of the world. The study looked only at how long people lived, however, and not how healthy they were whey the died, or how they rated their quality of life.

Why would overweight people live the longest?

Flegal and her co-authors suggest that it’s possible that overweight and obese people get better medical care, either because they show symptoms of disease earlier or because they’re screened more regularly for chronic diseases stemming from their weight, such as diabetes or heart problems. There is also some evidence that heavier people may have better survival during a medical emergencies such as infections or surgery; if you get pneumonia and lose 15 lbs, it helps to have 15 lbs to spare, for example.

Another possible explanation may involve “reverse causation”: maybe being thin doesn’t make you sick, as some experts argue, but instead being sick can make you thin. Being overweight may be associated with longer lives if people who lose weight because of diseases such as cancer, for example, contribute to earlier death among individuals who weigh less.

Flegal also says her findings may necessarily be contrary to previous studies about the relationship between BMI and mortality because those analyses used a variety of different BMI categories with different cut-points for the various weight groups. In the new JAMA study, Flegal and colleagues only looked at research using the WHO categories. Even so, she acknowledges that interpreting the results may be confusing, since the names of the WHO “normal” and “overweight” categories don’t necessarily correspond to commonly held perceptions. Today, roughly 33% of U.S. adults are clinically overweight, according to WHO standards, and an additional 36% are obese. By those standards, the average American is not clinically normal weight at all, but considered overweight. So in fact, the overweight people in the study who tend to live longest may not be fatter than most people at all. Among Americans, at least, they may actually be of average weight.

In addition, say doctors, weight alone may not be enough to understand an individual’s risk of developing disease and dying early. The latest research shows, for example, that it’s not just the fat that comes with weight gain, but the type of fat, particularly fat that accumulates around the belly, that might be more life-threatening. All of which suggests that the connection between weight and health is a complicated one that may not be measured simply in years lived.

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I've never seen anyone break a leg, get hit by a car, get bitten by a rattlesnake, or fall off a cliff while sitting in a chair. In the 1970s Dr. Jim Fixx popularized jogging for health. He died of a massive heart attack while jogging. Risk isn't always what it appears. Sedentary people by definition avoid a lot of risky behaviors more active people routinely engage in. If anything in this world is dangerous it's simple generalities and presumptions.

Staying at a healthy weight helps in so many ways and it's not only the workout or program you choose, but also how you eat and what you put into your body that makes a huge difference in the overall outcome. Staying strong is not only physical, but mental and the cleaner the items you put in your body, especially protein boosters, the cleaner the outcome.

The title of this article in Time is somewhat misleading in its use of the term "overweight" to describe a group of individuals at relatively low risk for premature death. Having read the original JAMA article as well as other evidence in the literature, I believe the following conclusions are justified, some more tentatively than others, as a better description of the evidence.

1. The BMI is an imprecise measure of deviations from optimal weight and body fat. Nevertheless, as a rough approximation, being underweight or seriously overweight by a BMI estimate is associated with an increased risk of premature death.

2. The standard BMI categories are probably poorly drawn. When "normal" is defined as 18.5 to <25, it probably averages some underweight individuals together with those whose weight is in a healthier range. In fact, some earlier studies that defined "normal" as 20 to <25 (thereby excluding those at the low end), found their "normals" to have lower mortality rates than those in the overweight (25 to <30) category, and of course much lower than those in the obese categories. Perhaps, an "ideal" BMI might be somewhere in the 23-26 range, while recognizing the inadequacy of the BMI as a definitive predictor of risk. Anyone in this range should probably feel comfortable staying there.

3. The distribution of body fat is critical. Excess intra-abdominal fat - the kind the produces the "spare tire" look - is probably hazardous. On the other hand, slight excess involving the arms, legs, hips, and buttocks is probably harmless, and in the absence of excess intra-abdominal fat might even confer some net benefit, such as protection against hip fractures in the elderly.

4. The U.S. has a severe obesity problem that is likely to worsen over time without serious attention to our dietary and exercise habits.

What we have to understand is that skinny does not equal healthy. In generations back skinny meant lack of nutrients and poverty not healthy. Those who eat more take in more nutrients and suffer from less malnutrition, they are often healthier than those who are thin

Skinny can mean A.I.D.S, Cancer,drug addiction or lack of nutrition. The fashion industry has caused us to believe skinny is healthy( Why anyone would listen to the fashion industry is anyone's guess)

First of all, this is not about being fat or obese it's about being slightly overweight which to me makes sense. Slimming down to bone after stressing the body will leave nothing left in the unfortunate event that you suffer a debilitating setback.

Gotta love it when the headline on Time's main page says "Obesity Linked to Lower Mortality Risk", yet the article says "... obese people, and particularly those who are extremely obese, tend to die earlier than those of normal weight. But the findings also suggest that people who are overweight (but not obese) may live longer than people with clinically normal body weight." So... not only was Obesity *NOT* linked to a lower mortality risk but, in fact, the opposite is true.

Very specious conclusions. If you check the real facts, "overweight" in this study is not the morbid obesity that is killing many more Americans every year. It is the very questionable "healthy height/weight tables" that makes many of us "overweight" and includes many that appear to be of healthy normal weight.Truth be told, any one of us knows all too well from our life experience that true obesity is very unhealthy, limits life choices and lifespan greatly, and wastes most of life's precious moments for those afflicted by keeping them chained to the supermarket, the kitchen and the bathroom. Obesity is more than a sickness, it is an epidemic, as today even those in poverty have more than enough to eat compared to early days. This epidemic of obesity is truly a profound abuse and negative example of our national "embarassment of riches" compared to pre-WWII America.

I think this story should be treated very carefully. It does make the distinction, lower down in the text, between overweight and obese. But in the public consciousness, these two are often treated as the same. "Overweight" in medical terms is very different than the popular image of "overweight," which people associate with being visibly obese. There are many people who are a few pounds over the weight their doctors consider ideal but who, to the public at large, would never qualify as being overweight. I suspect the study more encompasses those former kinds of folks, not the obese, who usually have a high risk factor for one or more diseases. I also agree with the person who says that BMI does not take body composition into account (nor does it include a person's family medical history).

Thank You commentonitall. I'm 5'11 and currently weight 175 now and feel like a bean pole. I do cardio about 5 - 6 times a week yet would kill to gain 10 lbs of mass just to fill in all the skin pouches I have (I lost 125 lbs within a year so my skin sags until i can tone better) The BMI states I technically am overweight and if I lose 3 mor lbs I would be considered normal :o I feel as long as you feel healthy get checked out as healthy and don't have any health issues then you shouldn't rely on something so flawed and will not take into account body types (bigger bones and health ailments like thyroid issues for women) and fat vs muscles.

I think the reason is outside factors, as in heavy people tend to do less, therefore they are exposed to less risks and dangers. For example heavy people may not ride a bike as much as healthy people, therefore the healthy people have a higher risk of dying because of their exposure. Another reason is that BMI does not look at muscle mass. For example I am 5'11 and weigh 191 pounds. According to the BMI index I am overweight, but in reality I go to the gym 5 times a week and am in great physical health and very toned, I just happen to have a lot of muscle. Most football players are probably considered "overweight" as well. This study fails to address very simple explanations and should look at muscle mass vs. fat. Then the results would make more sense.

This is just what fat people need: an excuse to eat more and not exercise. "See, we FAT people are the healthy ones. Not you who exercise and eat right. Gimme another Double Whopper and an extra large milkshake, hold the exercise...."

Living longer may not be as important as living healthier. BMI is a flawed metric and basing scientific conclusions on an erroneous assumption can only serve to confuse. It would be interesting to see how these findings would change if the upper limit of the ‘normal’ BMI were to be raised to 27. The bigger worry, nevertheless, is obesity, and for study purposes defining the threshold criteria that separates the overweight from obese is critical.